My tooth hurts when something cold or hot touches it,


Q: My tooth hurts when something cold or hot touches it, even when I breathe in cold air. I also have a chip or a hole at the back of the tooth. I don't know if I should get it pulled or if a root canal will fix the problem.

Symptoms:  No symptoms just pain and discomfort

A:   Hello,
Welcome to ATD. Thank you for the query.

Sensitive teeth are typically the result of worn tooth enamel or exposed tooth roots. Sometimes, however, tooth discomfort is caused by other factors, such as a cavity, a cracked or chipped tooth, a recently placed filling or a side effect of other dental procedures, such as bleaching.

If you're concerned about sensitive teeth, start by visiting your dentist. He or she can identify or rule out any underlying causes of your tooth pain. Depending on the circumstances, your dentist might recommend:

Desensitizing toothpaste. After several applications, desensitizing toothpaste can sometimes help block pain associated with sensitive teeth.
Fluoride. Your dentist might apply fluoride to the sensitive areas of your teeth to strengthen tooth enamel and reduce pain. He or she might also suggest the use of prescription fluoride at home.
Desensitizing or bonding. Occasionally, exposed root surfaces can be treated by applying bonding resin to the sensitive root surfaces. Local anesthetic might be needed.
Surgical gum graft. If your tooth root has lost gum tissue, a small amount of gum tissue can be taken from elsewhere in your mouth and attached to the affected site. This can protect exposed roots and reduce sensitivity.
Root canal. If your sensitive teeth cause severe pain and other treatments aren't effective, your dentist might recommend a root canal — a procedure used to treat problems in the tooth's soft core (dental pulp). While this might seem like a significant treatment, it's considered the most successful technique for eliminating tooth sensitivity.
To prevent sensitive teeth from recurring, your dentist might offer suggestions to help you maintain your oral health. Twice a day, brush your teeth with a soft-bristled toothbrush and fluoride toothpaste. Floss daily. Avoid vigorous or harsh scrubbing, highly abrasive toothpaste, and excessive brushing and flossing. If you grind your teeth, ask your dentist about a mouth guard. Tooth grinding can fracture teeth and cause sensitivity.

You might also consider limiting acidic foods and drinks, such as carbonated drinks, citrus fruits, wine and yogurt — all of which can remove small amounts of tooth enamel over time. When you drink acidic liquids, use a straw to limit contact with your teeth. After eating or drinking an acidic substance, drink milk or water to balance the acid levels in your mouth.

It also helps to avoid brushing your teeth immediately after eating or drinking acidic substances, since acid softens enamel and makes it more vulnerable to erosion during brushing.

Hope this helps. Take care.

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